title: Laparoscopic versus open repair of perforated gastroduodenal ulcer: a National Surgical Quality Improvement Program analysis.
abstract: BACKGROUND
  Surgical repair of perforated gastroduodenal ulcers remains a common indication for emergent surgery. The aim of this study was to test the hypothesis that the laparoscopic approach (LA) would be associated with reduced length of stay compared to the open approach.
  
  
  METHODS
  Patients with acute, perforated gastroduodenal ulcer were identified in the National Surgical Quality Improvement Program database, of whom 50 had the LA. One-to-one case/control matching on the basis of age, American Society of Anesthesiologists class, gender, and cardiac disease was evaluated for outcome analysis.
  
  
  RESULTS
  After matching, the 2 groups had similar characteristics. The rates of wound complications, organ space infections, prolonged ventilation, postoperative sepsis, return to the operating room, and mortality tended to be lower for the LA, although not significantly. Length of hospital stay was, however, significantly shorter for the LA by an average of 5.4 days.
  
  
  CONCLUSIONS
  The LA appears to be safe in mild to moderately ill patients with perforated peptic ulcer disease and is associated with reduced use of hospital resources.
authors.affiliation: Division of General Surgery, Section of Acute Care Surgery, University of Utah, School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA. Electronic address: nickolas.byrge@hsc.utah.edu.
authors.forename: Nickolas
authors.initials: N
authors.lastname: Byrge
authors.forename: Richard G
authors.initials: RG
authors.lastname: Barton
authors.forename: Toby M
authors.initials: TM
authors.lastname: Enniss
authors.forename: Raminder
authors.initials: R
authors.lastname: Nirula
mesh_terms: D004381:Duodenal Ulcer / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000601:surgery*; D058996:Quality Improvement; D013276:Stomach Ulcer / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome
keywords: Duodenal; Gastric; Laparoscopic; Peptic; Ulcer